64层螺旋CT冠状动脉成像临床应用评价

目的:评价64层螺旋CT冠状动脉成像(64SCTCA)的图像质量和在诊断冠状动脉疾病的临床价值。方法:搜集35例患者64SCTCA的完整资料,并以近期实施的选择性X线冠状动脉成像(SCA)结果为金标准进行对比,对64SCTCA显示的冠状动脉主支及主要分支情况进行分级评估。结果:35例病例可用于评估的冠状动脉共计368支,成功率达95.6%。其中SCA共显示74个节段冠脉有中、重度狭窄(≥50%)。MSCTCA诊断中重度狭窄的敏感性为86.5%,特异性为97.3%,阳性预测值88.9%,阴性预测值96.6%。经配对χ2检验,P>0.05,证明两种检查方法在发现冠状动脉病变方面差异无统计学意义。结论:64层螺旋CT冠状动脉成像是一种无创、快速的成像方法,对诊断冠状动脉≥50%狭窄有较高的敏感性和特异性,适合用于临床怀疑冠心病的患者SCA前的筛选检查。

The clinical assessment of 64-slice computed tomography coronary angiography

Objective:To evaluate the image quality of CT coronary angiography(CTCA) and the clinical values for the assessment of coronary disease with a 64-slice CT scanner.Methods:Assessment of the major and minor branches of coronary arteries by 64-slice CTCA,showed the information of 35 patients with 64-slice CTCA,comparing with selective coronary angiography(SCA) regarded as golden standard recently implemented.Results:Among the 35 patients,368 coronary arteries were evaluated,and 74 of 368 segments were found stenosis.The sensitivity,specificity,positive and negative predictive value of CTCA to identify over 50% stenosis were 86.5%,97.3%,88.9%,96.6%.Conclusion:64-slice spiral CT coronary angiography is a noninvasive and fast method that allows reliable diagnosis of coronary artery stenosis with high image quality,and has excellent sensitivity and specificity in detecting over 50% coronary artery stenosis,which is a screening inspection before SCA in symptomatic patients.